Care of depression in the elderly: comparative pharmacokinetics of SSRIs.

Details

Serval ID
serval:BIB_A1E0EEC5BEC3
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Care of depression in the elderly: comparative pharmacokinetics of SSRIs.
Journal
International clinical psychopharmacology
Author(s)
Baumann P.
ISSN
0268-1315 (Print)
ISSN-L
0268-1315
Publication state
Published
Issued date
09/1998
Peer-reviewed
Oui
Volume
13 Suppl 5
Pages
S35-43
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
Citalopram, fluoxetine, fluvoxamine, paroxetine and sertraline are the selective serotonin reuptake inhibiting antidepressants available. They differ by their chemical structure, metabolism and pharmacokinetics. Cytochrome P-450 of the liver plays an important role in their metabolism, but CYP1A2, CYP2C19, CYP2D6, CYP3A4 and possibly some other isoforms differ by their relative contribution. Citalopram and fluoxetine are available as racemic compounds: stereospecificity of their enantiomers has been shown for their serotonergic pharmacology, metabolism and kinetics. The pharmacokinetics of drugs may be modified in elderly patients, at different levels: absorption, distribution, metabolism and excretion. In these patients, depending on the selective serotonin reuptake inhibitor (SSRI) used, it is recommended to adapt the dose of the antidepressant: Lower doses should be used for citalopram, paroxetine and probably also for sertraline, when therapy is initiated. No clear evidence was found for fluoxetine and fluvoxamine concerning an age dependent metabolism. As elderly depressive patients may also suffer from somatic diseases, this should be considered in the choice of the dose of an SSRI, as for some of them, elimination is decreased in hepatic (citalopram, fluoxetine, fluvoxamine, sertraline) or renal (paroxetine) impairments.
Keywords
Aged, Aged, 80 and over, Antidepressive Agents/pharmacokinetics, Antidepressive Agents/therapeutic use, Depressive Disorder/complications, Depressive Disorder/drug therapy, Depressive Disorder/metabolism, Humans, Kidney Diseases/complications, Kidney Diseases/metabolism, Liver Diseases/complications, Liver Diseases/metabolism, Selective Serotonin Reuptake Inhibitors/pharmacokinetics, Selective Serotonin Reuptake Inhibitors/therapeutic use
Pubmed
Web of science
Create date
12/01/2021 16:16
Last modification date
15/04/2023 5:51
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